Initial experience and potential applications of multiplane transesophageal echocardiography

Abstract Transesophageal echocardiography (TEE) has become an accepted diagnostic cardiac ultrasound technique. The approach provides new, clinically relevant information in a large variety of diseases of the heart and great vessels. 1,2 Indications for TEE are further developing, and the safety of the method has been documented. 3 However, most studies describing the value of TEE were performed using monoplane transducers that enable multiple but exclusively horizontal images. Biplane transesophageal echocardiographic probes, enabling both transverse and longitudinal image planes, provide additional anatomic details, particularly concerning such vertically oriented structures as the superior vena cava, interatrial septum, ascending aorta, left atrial appendage, mitral valve and left ventricle in a long-axis view. 4–9 Most biplane probes use 2 separate transducer arrays mounted proximally and distally at the tip of the endoscope, so that adjustment of the position of the probe is needed when scan planes are changed. The matrix probe 4 enables synchronous side-by-side biplane imaging from 1 transducer location, but has a reduced frame rate and a limited number of transducer elements per plane. Recently, prototype multiplane transesophageal echocardiographic probes were made available; these enable stepwise examination of an area of interest by minute rotation of the scan plane through 180 °, using a fixed transducer position in the esophagus. This report describes our initial experience with multiplane TEE and discusses potential clinical applications.